探讨类似卵巢性索肿瘤（UTROSCT）的子宫肿瘤的临床病理特征、诊断、手术治疗及预后。回顾性分析7例UTROSCT的临床资料、手术方式、组织病理学和免疫组化特征并进行随访。所有 4 名患者均为绝经前女性。最常见的临床表现是月经过多（n = 4），其次是绝经后下腹部包块（n = 2）和绝经后出血（n = 1）。妇科超声提示子宫肌瘤4例，子宫腺肌病合并子宫肌瘤2例，宫内包块1例。仅2例术前进行盆腔MRI检查，均提示子宫肌瘤变性，其中1例疑似恶性肿瘤。术前检测6例患者血清肿瘤标志物，仅1例患者CA125水平升高，高达158 U/mL。全子宫切除术加双侧附件切除术或输卵管切除术是最常见的治疗模式（n = 6）。肿瘤位于子宫肌层（n = 4）、粘膜下层（n = 1）和峡部至宫颈外口（n = 1），范围为2至12（平均 = 8）cm。水肿、变性2例，坏死1例。术后随访时间为 31 至 82（平均 = 43）个月。不幸的是，1 名患者在随访 54 个月时死亡，但未接受子宫切除术。其余6例术后未见肿瘤复发或转移。组织学检查发现肿瘤由呈索状、小梁和巢状排列的上皮样肿瘤样细胞组成。所有 7 个肿瘤均表达 2 种性索分化标记物。此外，所有肿瘤均表达平滑肌标记物，而上皮标记物CK (4/7)。子宫内膜基质标志物CD10(0/7)。 Ki-67 增殖指数被发现<5% (5/7)。对于没有任何生育要求的女性，可以考虑选择全子宫切除术。然而，对于希望保持生育能力的年轻女性来说，保留子宫的手术可能是一种选择，尽管这需要仔细的术后监测。在后续监测方面，MRI比超声更适合。 UTROSCT 的诊断很大程度上依赖于组织病理学检查和免疫组织化学分析。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 出版

To investigate the clinicopathological features, diagnosis, surgical treatment and prognosis of uterine tumors similar to ovarian sex cord tumors (UTROSCT). The clinical data, surgical approach, histopathological, and immunohistochemical features of 7 cases of UTROSCTs were retrospectively reviewed and followed up. All 4 patients were premenopausal women. The most common clinical presentation was menorrhagia (n = 4) followed by postmenopausal lower abdominal mass (n = 2) and postmenopausal bleeding (n = 1). Gynecological ultrasonography suggested uterine fibroids in 4 cases, adenomyosis with uterine fibroids in 2 cases, and an intrauterine mass in 1 case. Pelvic MRI was performed preoperatively in only 2 cases, and both indicated uterine fibroid degeneration, including 1 patient with suspected malignancy. Preoperative serum tumor markers were measured in 6 patients, and only 1 patient had elevated CA125 levels, up to 158 U/mL. Total hysterectomy with bilateral adnexectomy or salpingectomy was the most common treatment pattern (n = 6). The tumors were located within the myometrium (n = 4), submucosa (n = 1), and isthmus to external cervical os (n = 1), with a range of 2 to 12 (mean = 8) cm. Edema and degeneration were observed in 2 cases, and necrosis in 1 case. Postoperative follow-up ranged from 31 to 82 (mean = 43) months. Unfortunately, 1 patient died at 54 months of follow-up without undergoing hysterectomy. The remaining 6 cases showed no tumor recurrence or metastasis after surgery. Histological examination revealed a tumor composed of epithelioid tumor-like cells arranged in cords, trabeculae, and nests. All 7 tumors showed expression of 2 sex cord differentiation markers. Furthermore, all tumors expressed the smooth muscle marker, while epithelial marker CK (4/7). endometrial stromal marker CD10(0/7). The Ki-67 proliferation index was found to be <5% (5/7). The option of total hysterectomy may be considered for women who do not have any fertility requirements. However, for young women who desire to maintain their reproductive capacity, surgery to preserve the uterus may be an alternative, although it necessitates careful postoperative monitoring. In terms of follow-up monitoring, MRI is more suitable than ultrasound. The diagnosis of UTROSCT heavily relies on histopathological examination and immunohistochemical analysis.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.